Situational Breath Control of Patients in Cardiac Surgical Rehabilitation

Abstract

Postoperative cognitive dysfunction is a common complication of central nervous system damage in middle-aged and elderly patients following cardiac surgery. It significantly impacts the prognosis, treatment outcomes and quality of life. Cognitive training can improve cognitive reserve, thereby reducing postoperative delirium. In Russian cardiac surgery, there are established, evidence-based prehabilitation programmes aimed to overcome the consequences of surgical intervention, based on training techniques and an interdisciplinary approach. The authors studied new algorithms for improving the effectiveness and reliability of teaching breathing practices when preparing patients with ischaemic heart disease for coronary artery bypass surgery. The purpose of this article was to evaluate the clinical efficacy of teaching situational breathing strategies to patients after open-heart surgery. Materials and methods. A total of 73 patients (58 men and 15 women) with stable ischaemic heart disease who underwent coronary artery bypass surgery at Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo, Russia) were examined. Their mean age was 64.4 ± 5.1 years. In preparation for surgery, the patients were randomized into two groups comparable in terms of key anamnestic and clinical-functional parameters: the main group (38 subjects), who was taught breathing pattern regulation techniques, and the control group (35 subjects), who did not receive such training. Results. It was found that preventive psychological care, including motor memory training in breathing pattern regulation, reduces the severity of postoperative cognitive impairments and increases patients’ compliance with postoperative recommendations, which determines the dynamics of respiratory complications.